Alive-PD has been developed and tested….

Alive-PD is being developed and tested through a grant to NutritionQuest from the National Institute of Nursing Research, one of the U.S. National Institutes of Health.

Alive-PD strategies to promote behavior change

Alive-PD employs concrete behavioral management strategies for : initiating healthier behaviors; sustaining them, even when motivation lags; and making them enduring habits. Some key strategies include setting short-term, step-by-step goals; self-monitoring; anticipating barriers; and rewarding accomplishment, in several ways. enriching both skills and knowledge.

Those strategies are built on a broad foundation of scientific research and theory, ranging from traditional health behavior change models and learning theories to more recent findings in fields such as Positive Psychology and Behavioral Economics.

Assessment forms the basis for small-step personalized goals

The program uses its online Health Risk Assessment (HRA) questionnaire to measure dietary habits and activity levels, and to identify lifestyle characteristics, preferences, and psychosocial factors that are essential to individualizing the program. The assessment provides the basis for individually tailoring specific goals and tips for changes in diet, physical activity and weight control. It determines each participant’s baseline aerobic, strength-building and sedentary activities, and uses that to create a personal Activity Plan (described below) to gradually move participants forward. The dietary component, derived from the widely used Block Dietary Assessment Questionnaire, assesses consumption of foods important in the prevention of diabetes. This detailed information becomes the basis of suggested small-step weekly dietary goals.

Instant Feedback

An online summary of the individual’s diet and activity status in relation to recommended levels serves as a motivator for participation, and a guide to the individual regarding specific behaviors that need particular attention.

The Personalized Activity Plan

Based on the participant’s reported level of activity, the program suggests a detailed Activity Plan of daily/weekly minutes of physical activity, designed to move the participant from their baseline level to a recommended level. The suggested rate of increase from week to week depends on the participant’s age and obesity status. Although the program suggests a plan, the participant may customize or completely change it at any time. Weekly activity goals recommended by the program are based on the personalized Activity Plan.

Weekly goal-setting

Each week, the program suggests small-step goals for the coming week. Activity goals are based on the participant’s Activity Plan. Suggested food goals are constructed from: the participant’s responses to the food questionnaire; the nutrient and food group analysis; and the participant’s past performance with setting and achieving goals. Weekly goals also include “attitude” actions, involving positive psychology, self-compassion, self-rewarding, and other behavioral principles.

Reminders

In mid-week, the program reminds the participant of the goals he/she chose for the week, or reminds them to choose goals this week. Participants can configure the number of reminders to be sent each week.

Reporting and logging

Each week, the participant uses the online system to report whether or not the goals chosen last week were achieved. In addition, a logging system allows the participant to log body weight, hemoglobin A1c, glucose, minutes of activity, foods eaten, and other user-configurable metrics. The results are graphed to show change over time.

Coaching tool

If the participant reports difficulty achieving their selected goals, the program suggests a visit to the Coaching Tool. There, the participant chooses the topic requiring coaching and the barrier that is interfering with achieving the participant’s goals. The program suggests methods, tips and strategies for overcoming those barriers.

Information and skills

Each week two topics are covered in Health Notes. These brief educational pieces provide information about diabetes, causes and consequences, and the behavioral changes needed to reduce the risk. In addition to eating habits, physical activity and weight loss, the Health Notes cover factors such as stress, sleep problems, and other related health conditions such as serum cholesterol.

In addition to the Health Notes, the program uses weekly info-graphics and other learning aids to convey core concepts and messages in a visual, easy to understand style.

Promotion of social support

Social support is promoted in several ways. In the team system (described below) participants may message each other with pre-drafted or personalized motivational messages. Health Notes may be emailed or posted to Facebook, Twitter, or Google+. In addition, the program facilitates support by family and friends by emailing the participant’s weekly Health Notes to the family/friend, and allowing them to send support messages directly into the participant’s Alive inbox.

Tailoring

Alive-PD is highly individualized, providing each participant with a program that is personally relevant and engaging. Components tailored to the individual include the diet and activity HRA (tailored to age, gender, ethnicity), feedback from the HRA (tailored to individuals’ reported foods and activities), weekly recommended goals (tailored to food habits, activities and past performance), and Health Notes (tailored to gender and ethnicity). Participants may also personalize their web page with inspirational quotations, an inspiring image, nickname, and other features .

Strategies to maintain participation and prevent drop-outs

Without active participation, behavioral principles and effective behavior-change techniques are wasted. Several components of Alive-PD are designed to maintain interest and engagement. For more information check out the results of our randomized trial under Current status below.

Points system

Interaction and engagement with central components of the program is promoted using a points system. Participants are awarded points for setting and reporting goals; successfully accomplishing goals; reading Health Notes and taking related quizzes; logging body weight, activity, dietary intake, A1c/glucose; and sending support messages to other Alive-PD participants.

Quizzes

There are new quizzes each week on the participant’s home page. In addition, each Health Note includes a quiz covering the topic of the Health Note. Participants earn points for completing quizzes.

Team system

Alive-PD includes a system in which participants can play on teams, to encourage support among participants and to facilitate friendly competition. Organizations offering the program may configure any number of teams, of any size, and may elect to have participants either randomly assigned to a team or placed onto a specific team. The program can be configured to provide incentives to winning teams.

Team members can send messages and challenges to each other through the system.

Individual challenge

Individuals, whether on a team or not, can compete for rewards. Chances of winning are based on the individual’s level of participation with the program, as measured by the points system. The reward is monetary and can be scaled to the needs and budget of the organization offering the program. Winning participants may choose whether to receive their reward or to donate it to the American Diabetes Association or another recognized charity.

Smartphones, tablets, automated coaching calls

Participants can choose to opt in or out of this component.

Smartphone app

Smartphone app – Alive-PD includes an Android and iPhone app which extends program functionality to the participant’s smartphone. The app allows participants to select Alive-PD weekly goals, report on accomplishment of previous goals, and set calendar reminders. The program also reinforces selected goals via push notifications, and coaxes potential dropouts to engage with the program.

Tablet and smartphone accessibility

The entire Alive-PD program is compatible with delivery and use on tablets, and full accessibility on smartphones is expected June, 2016.

Automated Phone Coaching

Alive-PD delivers an automated telephone coaching phone call every two weeks using Interactive Voice Response (IVR). The IVR system automatically tailors messages using real-time data related to the participant’s interactions with the program, stated reasons for wanting to lose weight or eat better, and previously reported barriers. In addition, the IVR asks the participant about current barriers or situations they would like coaching on, and delivers appropriate suggestions.

Tailored Coaching Newsletter

A tailored coaching newsletter is under development, to be delivered monthly.